The role of active Na+ transport by lung epithelium in the clearance of airspace fluid.

Clinical and laboratory-based studies of pulmonary edema have usually focused on the mechanisms responsible for the production of the edema and how therapeutic maneuvers can oppose or treat such processes. Recently, there has been increasing interest in the mechanisms involved in the clearance of airspace fluids. These studies have demonstrated that active transport of Na+ by the distal lung epithelium plays an important physiologic role in the clearance of pulmonary edema fluid. Specifically, the ability of the lung to clear its fluid by active transport processes correlates with survival from high-pressure or high-permeability pulmonary edema. Also, studies have shown that immaturity of Na+ transport processes and, specifically, inadequate expression of Na+ channels contribute to the pathogenesis of respiratory distress syndrome in the newborn.